CARE HOME ADULTS 18-65
Wilson Lodge 16 Augusta Road East Moseley Birmingham West Midlands B13 8AJ Lead Inspector
Kath Strong Unannounced Inspection 26th September 2005 09:30 Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Wilson Lodge Address 16 Augusta Road East Moseley Birmingham West Midlands B13 8AJ 0121 449 1841 0121 449 2926 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Wilson Care Resources Ltd Mr Malcolm Wright Care Home 36 Category(ies) of Learning disability (36), Mental disorder, registration, with number excluding learning disability or dementia (36) of places Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 36 adults over 30 years and below the age of 65 years - mentally ill persons with learning disabilities That the manager succesfully completes the Registered Managers Award (NVQ Level 4 in Care Management) or equivalent by April 2005 13/04/05 Date of last inspection Brief Description of the Service: Wilson Lodge was purpose built in the 1970’s and commenced operating as a residential home. The registration status changed at a later date to nursing care for up to 36 adults suffering from mental health problems. Residents may also have a learning disability but mental health illness is the primary reason for admission. The home is situated within a residential area, close to the city centre and within walking distance of local shops and other amenities. As well as the registered manager the home employs a nurse manager. The ethos of the home is encouraging and supporting independence of residents. Accommodation is spread over two floors offering a mixture of single and shared rooms. Communal areas include two lounges, a dining room, a smoking room and two small secluded gardens. There are dedicated kitchen and laundry facilities on the premises. The building is located at the end of a cul-de-sac and provides turning facilities at the front of the home but no off road parking for visitors. Car parking facilities for staff are situated at the rear of the property. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of the visit was to conduct an unannounced inspection and the outcome was determined by a number of means. In depth discussions were held with the registered manager and the nurse manager. Individual discussions were also held with seven residents and two staff. Observations involved staff interactions with residents. Relevant documentation was examined including three sampled care plans. A partial tour of the premises was carried out. At the conclusion verbal feedback was provided to the registered manager and the nurse manager. This inspection involved examination of the progress made in respect of the requirements generated at the last inspection, the remaining core and a selection of other standards. To gain a complete overview of the home it is recommended that the report from the previous inspection should be read in conjunction with this one. What the service does well: What has improved since the last inspection?
The main office has had a new desk and a number of new cabinets installed. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 6 A room housing two toilets has been converted into a spacious walk in shower room and a separate toilet. A ground floor bathroom was currently being fully refurbished and will include assisted bathing facilities. A nurse has undergone a trainer’s course in manual handling and the home has purchased relevant teaching aids. Manual handling training of staff is now carried out in-house and there is the additional benefit of regular monitoring of staff practices in this aspect of care. A gazebo has been purchased and erected in the garden, which is situated off the lounge at the side of the premises. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 5 Residents have not been issued with a copy of the service user guide thus restricting the amount of written information. All residents have been issued with a contract of terms of residency. EVIDENCE: Although the homes statement of purpose is comprehensive and assists prospective residents in making informed choices about the home, they are not issued with a copy of the service user guide upon admission. The registered manager advised that the document was being reviewed and on completion would be issued to each resident. All people who reside at the home are issued with a contract of terms and conditions of residency, which includes the room occupied, the current fee rate and details of any extra charges. Standards 2, 3 and 4 were examined and fully met at the last inspection. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Care plans are comprehensive and include all relevant risk assessments and support needed in meeting resident’s expectations and independence. Residents are consulted and assisted in maintaining their preferred activities of daily living. EVIDENCE: The three care plans examined included the two most recent admissions. The contents included medical, psychiatric and social history; the histories supplied valuable information in enabling the staff to identify individual’s needs. Files included sexuality, smoking, the level of support required and such details as the person’s ability to manage their financial affairs. One resident who has resided at the home for four years said, “I enjoy living at Wilson Lodge”. Another resident who, due to a recent injury is currently unable to go out said, “Another resident is doing my shopping for me until my arm gets better”. Upon her return to the home a resident reported that she had been to the police station and talked to the staff. The nurse manager stated that this is a regular routine, the resident is well known. Residents meetings continue to be held approximately monthly; the minutes indicate that residents influence the day-to-day operations of the home.
Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 15, 16 Residents are encouraged to have appropriate personal and family relationships and their rights are respected. EVIDENCE: Routines within the home are flexible. Staff promote individuals to adopt practical skills such as maintaining their own rooms and a rota is in place for residents to undertake garden maintenance tasks. A resident commented, “I like living here, its good company”. Many bedrooms include tea making facilities. Senior staff have developed an informative and co-operative relationship with relatives who are also invited to participate with some activities. External activities are provided twice a week for those who wish to be included. When required, residents are supported in maintaining close personal relationships. Standards 11, 12, 13 and 17 were examined and fully met at the last inspection. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The medication system deployed is well managed promoting good health. EVIDENCE: The pharmacist carries out regular audits on the home. Each resident has an up to date list of all medications. Due to the large amounts and complexity, two trained staff audit all medications received and disposed of. The process was examined and determined to be satisfactory. Standards 18 and 19 were examined and fully met at the last inspection. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home has a satisfactory complaints system in place EVIDENCE: Historically few complaints are made; none have been received by the home or CSCI since the inspection of August 2004. The written procedure and means of recording complaints were noted to be satisfactory. Standard 23 was examined and fully met at the last inspection. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 30 The standard of the environment is good providing residents with a pleasant, hygienic and homely place to live. EVIDENCE: The two lounges and the dining room are light and airy and contain a good standard of furniture and fittings. All communal areas are domestic in design and well maintained. A walk in shower facility has been installed on the ground floor and the home was in the process of fully refurbishing a ground floor bathroom to include assisted bathing. Bathrooms and toilets are strategically located throughout the home. Bedrooms viewed were noted to be very personalised. All rooms had suited door locks and were painted in individual colours representing ownership. All areas visited were found to be tidy, hygienic and odour free. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 Residents are protected by the homes robust staff recruitment system. All identified needs of residents were being met. EVIDENCE: The system deployed for the recruitment of staff was found to be satisfactory with all relevant checks being carried out before a post is offered. Staff demonstrated an in depth knowledge and good relationships with residents and were observed interacting well with them. Following the additional in-house manual handling training the mandatory programme was found to be satisfactory. Other training to meet the needs of the current client group is also supplied and requests made by staff are positively considered. Standards 33 and 36 were examined and fully met at the last inspection. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42 The quality assurance system had not been fully completed. All aspects of health and safety were met thus protecting residents and staff. EVIDENCE: The home regularly carries out health and safety and infection control audits and resident and relatives satisfaction surveys. The registered manager acknowledged that further work is required by producing a report and resultant action plan with timescales in order to complete the process. At the previous inspection all aspects of health and safety; with the exception of manual handling training, had been complied with. As discussed this aspect is now met. Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 X X X 3 Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X 3 3 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Wilson Lodge Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000024909.V254428.R01.S.doc Version 5.0 Page 17 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement The registered manager must complete the already commenced service user guide and supply a copy to each resident. N.B. This remains outstanding from the two previous inspections. The home must complete the development and implementation of an acceptable quality assurance system. N.B. This remains outstanding from the two previous inspections. Timescale for action 1 YA1 5(2) 31/10/05 2 24 (1) (a,b) (2) (3) 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wilson Lodge DS0000024909.V254428.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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